Acta cardiologica
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Hypertrophic cardiomyopathy is an important cause of sudden death in young and asymptomatic patients. Young athletes and patients with unexplained sudden death, including their relatives, should be screened for its presence. Risk stratification identifies a high-risk group, in which preventive measures should be taken to reduce the risk for sudden death: moderate to heavy physical activity has to be avoided and arrhythmias with haemodynamic impact should be rigorously prevented.
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Case Reports
Shoshin syndrome: two case reports representing opposite ends of the same disease spectrum.
Thiamine deficiency can have cardiovascular and neurological manifestations. Cardiac beriberi is classically thought to represent a high-output state with oliguria and lactic acidosis. The condition can, however, also present itself with a low cardiac output and fulminant vascular collapse, or as an acute fatal form, causing sudden death, without clear-cut signs of cardiomegaly. ⋯ We report on two cases, one with high-output failure and the other with low-output failure and cardiovascular collapse. In both patients the diagnosis of shoshin syndrome was made, and and both showed a spectacular improvement of congestive heart failure symptoms after treatment with thiamine. A therapeutic trial with thiamine is the only way to rapid diagnosis.
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Case Reports
Massive pericardial effusion in an adult case of congenital hypothyroidism due to a sublingual thyroid.
Acquired hypothyroidism is known to cause cardiac tamponade. However, pericardial effusion in cretinism in adulthood has rarely been reported. A 27-year-old dwarfish woman suffering from congestive heart failure was diagnosed with congenital hypothyroidism due to the presence of a sublingual thyroid. ⋯ Despite the existence of massive pericardial effusion, the patient had hypertension. Her metabolic abnormality responded dramatically to L-thyroxin. Pericardial effusion disappeared one year after the initiation of medical treatment.
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Case Reports
Successful treatment of staphylococcal pericarditis with early catheter drainage and antibiotics.
We describe a 26-year-old man with staphylococcal pericarditis who was treated successfully by percutaneous catheter drainage combined with antibiotics. One year later he remains in good condition without echocardiographic evidence of constriction.
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Comparative Study
Complications in spinal cord stimulation for treatment of angina pectoris. Differences in unipolar and multipolar percutaneous inserted electrodes.
Spinal cord stimulation (SCS) has become a well established treatment for ischaemic nociceptive pain condition such as angina pectoris. In patients not suitable candidates for coronary bypass grafting or intraarterial invasive technique (i.e. PTCA and Stent) SCS is an alternative. ⋯ Changes of electrode combination in connection with small migrations were necessary in 29% of the patients with multipolar electrodes. Therefore, there was no significant difference between frequency of migration for patients with monopolar or quadripolar epidural stimulation electrodes (p = 0.31). When SCS was used for treatment of anginal pain, the frequency of electrode tip migrations was high, but the use of multipolar electrodes gave the possibility to compensate for the migration, and to avoid surgical replacement.